By Dick Morris and Eileen McGann
Joseph Stubbs President of the American College of Physicians -- the second largest doctors group in the country -- confirms that the supply of doctors just wont be there for the 30 million new patients Barack Obama wants to cover. Noting that the doctor shortage is already a catastrophic crisis Stubbs said that underserved areas in the U.S. currently need almost 17000 new primary care physicians even before Obamas proposals are enacted.
In the meantime according to Bloomberg News a 2009 survey by Merritt Hawkins and Associates a recruiting and research firm in Irving Texas found that the average waiting time to see a family-medicine doctor in Boston ... is 63 days the most among the 15 cities surveyed. By comparison in Miami it was only seven days.
The study noted that Bostons longer wait was driven in part by the health-care reform initiative passed in 2006 in Massachusetts upon which the Obama program is modeled. Bloomberg reported that as many as half of doctors in the state have closed their practices to new patients forcing many of the newly insured to turn to emergency rooms for care.
Alan Goroll a professor at Harvard Medical School said that the primary lesson of health-care reform in Massachusetts is that you cant increase the number of insured unless you have a strong primary-care base in place to receive them. Without that foundation ... Massachusetts has ended up with higher costs and people going to emergency rooms when they cant find a doctor.
And a study by the Centers for Medicare and Medicaid part of the federal governments Health and Human Services Department found that expanding insurance coverage to an estimated 32 million people who now lack it would create a demand for medical services that could be difficult to meet initially ... and could lead to price-increases cost-shifting and-or changes in providers willingness to treat patients with low-reimbursement health coverage.
Indeed the report found that the Medicare cuts contained in the House-passed bill are likely to prove so costly to hospitals and nursing homes that they could stop taking Medicare altogether.
The dynamic of the health care debate is decidedly turning against the administration. As details of the doctor shortage Medicare cuts tax increases penalties for no insurance shallow subsidies and high costs for the uninsured all leak out more and more Americans are developing qualms about the bill.
But within Congress the momentum is the other way as the bill hurtles toward December passage in the Senate.
But then it will hit a wall as the houses try to reconcile their different versions so as to satisfy the liberal House and Obamas base on the one hand and the most conservative among the 60 Democratic senators on the other. This debate will focus on such a broad range of issues and will be so contentious that it is going to take a long time to resolve.
Meanwhile popular angst with the bill will continue to build and Election Day will approach. More and more members will be anxious about supporting the bill and both left and right will dig in their heels and resist compromise.
The health care bill may pass both houses but may not be able to be enacted into law. The tide of public opinion cannot be resisted.
Dick Morris a former political adviser to Sen. Trent Lott (R-Miss.) and President Bill Clinton is the author of Condi vs. Hillary: The Next Great Presidential Race. To get all of Dick Morriss and Eileen McGanns columns for free by email go to www.dickmorris.com
